Tuesday, 27 January 2015

2 weeks post-op

The last few days since the update have found the whole area recovering very nicely. I do have some suture lines opening and from listening to others, this is actually quite common. At the base of the vagina, there are two pairs of lines of sutures and in amongst this is a triangle of open wound. It is not bleeding and nothing to be alarmed about at this time. The future prospect is that I may get some granulation tissue in this area. It's easily accessible and will be easy to deal with down the line. We have also been concerned about tissue infection due to a light creamy brown discharge in this area, but a nurse looked at it yesterday (Monday) and said it all looked very healthy. I am advised to look for yellow or green discharge and the colour of what is emerging is more brown than yellow. The issue is that I have found just about every colour of the rainbow on my panty liner since the pack removal and sometimes you worry about silly little things.

We also found out on Saturday that we were not cleaning the area properly. For some strange reason, I had it in my mind that we had to leave the clitoral area alone. A re-read of the discharge notes found this was not the case and we had been ignoring this for 5 days. We then had to start over and this was a very interesting experience. Mandy has been doing all the cleaning because whilst I can do it if necessary with a mirror, it is actually much easier for someone else to do it. Now she cleans all the suture lines and then with fresh wipes, works around the clitoral area. Sensitive is an understatement! It is an indescribable feeling at this time, and the future looks very rosy where this is concerned! This cleaning has encouraged some bleeding at night but it is settling down. 

Yesterday (Monday) saw the removal of my catheter. I had been in the unlucky position of having to be re-catheterised 90 minutes after the removal in Brighton but I was optimistic about this time. Already in the few days before this, I had found I could urinate around the tube if I bore down whilst emptying it and I was hopeful that this time it was going to stay out. The nurses arrived at 9.30 and I do not think they were completely comfortable with the situation. Mandy picked up on this too and I am not sure what they took issue with. I led them into the bedroom, explained that I had had GRS and the issues with regards rearranging the urethra and the swelling. I must admit there uncomfortable attitude unsettled myself and we messed up on two counts. I was supposed to have emptied my bladder prior to removal and taken a photo for the next nurse if they needed to put yet another catheter in. None of this was done until after it was out and then it was too late. I felt that their whole attitude was to get the catheter out and get on to the next job. I could feel the removal of the catheter but it was not high on the pain scale, perhaps 2 out of 10 at a push.

I asked them to look at my wounds and they did, they felt it all looked healthy and not really any sign of infection. They gave me the standard advice for catheter removal, drink plenty and to wait until 12.00 if unsuccessful. I was already drinking cranberry juice and continued afterwards. I also had a fairly full bladder but I waited until I was absolutely desperate. The reasoning behind emptying prior to removal is to give the urethra time to settle before then using it but I now did not have this luxury. I waited as long as I could and then went to the toilet. Mandy followed me, she was as anticipatory as I was. I sat and wondered what I needed to do initially. This was all different, I'd had 40 years of a tube to pee out of and for the last week a tap! I kept sitting and nothing was happening, so I gently squeezed my pelvic muscles and put pressure on the bladder. I had to be very careful as too much pushing can cause my sutures line to bleed, as I had when I had my first bowel movement in Brighton. I would also guess that really pushing could even run the risk of a prolapse and this is something I definitely didn't want. I bore down a little harder and suddenly there was a trickle. It was very small at first but I learnt where to apply the pressure and increased it slightly. It did start to get painful in the bladder but I needed to keep going because a partially emptied bladder has more risk of a urinary tract infection (UTI). As it was, this very first time, I did not empty completely. I dabbed at everything with toilet paper and then gently wiped over with a baby wipe. This is advice from Brighton and is to prevent a possible occurrence of nappy rash. Because it goes everywhere initially, this is a high risk and something to be definitely avoided. Slowly as the day went by I started getting more proficient at being able to empty the bladder. I think there was an element of it calming down after having had an intrusion for 13 days and it got easier to completely empty. I also noticed that the flow was starting to get more random in it's direction. The first one was straight down but after it started going down and sideways. Bum cheeks were often left wet and every time became a clean up operation. it didn't matter because after all these years, I was suddenly urinating correctly. I also should mention that the district nurses did give me a call back to check I was ok. Their attitude was definitely offish when they were here but they did have the thought to check up which meant something.

By the end of the day going to the toilet was starting to become a lot more natural and easier. I could sit there and find the correct way to start it all off with much less effort than it had at the start of the day. It is so strange that it should feel so different to get it to work because essentially it's only the end of the plumbing that has been changed, the bladder and exit before the prostate are still the same. But it is definitely a much different experience and one that is actually quite profound. Now going to the toilet is the real deal whereas the forty years previous have been all wrong. Whilst toileting is mundane and trivial to some, for me at the moment it is marking another passage into the world of completeness. There was one moment yesterday when I went and automatically grabbed a penis that was not there to point it down into the bowl although I suspect that wont happen many more times. Towards the afternoon it was sounding correct too. It is a sound that you do not get with a penis and hearing it was another affirmation.

Dilation continues to go really well and a little easier too with the catheter removal. I have significantly reduced the lube I need because I was finding that so much was ending up on my backside. I appreciate that many will need the amount they suggest, but I am experiencing no difficulty of tightness on inserting the dilators. I am also increasing the time with the bigger one, sometimes 5 or ten minutes extra when I feel like it. I am also starting to find a little less blood on the dilators afterwards. To pass the time, I have found that I can read a book whilst dilating. It is not difficult and it make those 2 times 10 minutes a lot more enjoyable. Douching afterwards is now quite a natural experience, it's just something that is a part of the a normal shower. I have been using the trial one Liz Hills gave me and decided yesterday to give the EZ Streem a comparison usage. I must admit that I had difficulty with it due to it's straight nozzle. The new one has a curved nozzle and it was only after a few days of getting used to it, did I realise how much harder the EZ Streem is. It is not a problem, but you do have to remember to angle it in and then straighten once you have reached the pelvic floor muscle. The new one, you do not have to do this, it slips straight in.

Physically myself, I find myself in very good shape. I am obeying the house arrest Brighton but at times it feels like I have to force myself to. Now that the catheter is out, I may if the weather is good, go out for a short walk. I am as active as I can be around the flat and potter around the kitchen where possible. The only issues are lifting and I am obeying the 2kg limit as set out in the discharge notes. Since the day after surgery, I have not felt tired at all during the day and even at home and more active, this has still not been the case. I wonder how much of this was down to my high level of fitness prior to going in?

Hormonally, I have started hot flushing much more in the last few days. These are getting quite intense and it's going to be an interesting week until I restart my hormones. The night sweats are even more of an issue and I wake in the night drenched. My body hair growth has slowed a little but not back to what it was yet. There's not much else to report on this.

Emotionally I am a bit of a mixture. I am tending to be very tearful. This is not an unhappiness but more of a connection to my inner self. Many things make me cry and I can get overwhelmed very easily. Writing about past issues can be very triggering and there have been a few times where I have ended in tears. If anything upsets me, I am crying straight away. In contrast, happy moments can also make me cry. It takes nothing to trigger this off and there have been some bewildered people on the phone recently! This is not their fault but they often take the crying the wrong way and think they have upset me. I suppose it must be difficult for many to understand why this is the case, and hell, even I can't understand it half the time. All in all, I am fantastically happy and contented and I do not think I have been in a better place, ever.

My GRS time-line :

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